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CHIROPRACTIC TECHNIQUE
TECHNIQUE CHIROPRACTIC
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Monika A. Buerger, DC
Chiropracti c truly is a Science, Art and Philosophy. When you understand the science, philosophy becomes more solid. When philosophy becomes more solid, the science becomes even more meaningful. The two have reciprocal consequences that lead to an increased level of confi dence and certainty in practi ce. This is the place where the art of chiropracti c then manifests at the highest energeti c level.
According to the Centers for Disease Control (CDC), the current rate of Auti sm Spectrum Disorder (ASD) in the United States is 1 in 44 children. In a paper released in September of 2021 in JAMA Pediatrics, researchers found that preempti ve interventi on for Auti sm Spectrum Disorder from age nine months among a sample of infants showing early signs of ASD led to reduced ASD symptom severity across early childhood and reduced the odds of an ASD diagnosis at age 3 years. So, what was this early interventi on? The answer to this is the framework for the future of pediatric chiropracti c from a neurodevelopmental perspecti ve.
I believe that in order to understand the answer to the above “early interventi on”, we should fi rst have some basic understanding of what is known from the current chiropracti c neuroscience literature. Studies done by top researchers, Heidi Haavik and her team, have repeatedly shown that adjusti ng the spine will infl uence the way that the Prefrontal Cortex (PFC) processes somatosensory informati on. Among a host of criti cal functi ons, the PFC is considered the “Executi ve Functi oning System” of the brain; it also controls our social engagement system. In the above noted study, the preempti ve interventi on given to reduce the odds of a later ASD diagnosis was that of coaching caregivers on appropriate social engagement interacti ons with their children.
The future of neurodevelopmentally based pediatric chiropracti c care is being able to look at what I call the NeuroMatrix and understanding WHEN during development did the insults occur, WHAT those parti cular insults may have been and WHERE did the insults potenti ally leave their mark on the developing nervous system. Proper social engagement with caregivers is essenti al for bonding. It is well known that caregiver bonding with newborns is important in order to establish a healthy relati onship between the child and their caregivers. Bonding is also necessary to foster healthy relati onships and emoti onal regulati on throughout one's life. However, this life altering process is also important in neurological development. Social engagement with caregivers, especially with mom, in the form of eye contact and infanti le directed speech, has shown acti vati on within the Medial Prefrontal Cortex (mPFC). Evidence suggests that the mPFC exhibits functi onal acti vati on much earlier than previously thought, suggesti ng that the mPFC is involved in social informati on processing from early in
life. The mPFC is also known to be important for human social cogniti on and behavior throughout life. Social engagement, parti cularly with mom, produces the important hormone He who knows things from their beginning oxytocin; also known as the "love drug" oxytocin helps us relate to others and strengthens trust and closeness in and origins understands relati onships. Oxytocin also acti vates them better … the vagus nerve which is the prime driving force of the parasympatheti c -Aristotle , 4th century BC nervous system and is responsible for the anti -infl ammatory arm of immune system modulati on, gastrointesti nal regulati on, heart rate and a host of other criti cal neurophysiological responses; all of which are known to be dysfuncti onal in those with neurodevelopmental disorders. In the world of neurodevelopment and neuropsychiatry, the maturati on of the autonomic nervous system, of which the PFC will be the primary regulator, is considered the neurobiology of physical, mental and emoti onal disease. I see the future of pediatric chiropracti c and neurodevelopment intertwined and working alongside (actually leading) those in other professions that understand that regulati on of the autonomic nervous system and processing informati on from our world is the key to health and development. If the chiropracti c adjustment helps to modulate processing of sensory informati on in the PFC, it stands to reason that it may also play a role in the development of proper social engagement and caregiver bonding. Therefore, getti ng children under chiropracti c care from the beginning of life could potenti ally steer the course of neurodevelopment and turn the ti de on a later diagnosis of auti sm or other neurodevelopmental disorders. Understanding the profound eff ect that chiropracti c care can have on the enti re life of a child is one of the most amazing and inspirati onal things that this profession has to off er!
TORQUE RELEASE TECHNIQUE® : A VISION OF THE FUTURE
Jay M. Holder, DC, DACACD, FICA Aaron M. Holder, DC, DACACD
Torque Release Technique® (TRT) debuted on campus at Life College in 1995, the fi rst technique of chiropracti c’s second century. TRT’s mission has always maintained that the singular purpose of adjusti ng the subluxati on is Salutogenic. TRT does not treat a conditi on, disease or symptom; it only proposes that in adjusti ng a subluxati on we can improve the pati ent’s state of wellbeing and human potenti al.
TRT is a technique but most important is its technique model. TRT is the only non-linear, vitalisti c and tonal model existi ng in chiropracti c today. There are several key issues that make up this model of which we will only list a few. First there is our diff erenti al diagnosis of ruling out the many secondary and terti ary subluxati ons to determine the primary subluxati on. One of TRT's methods to perform this is our functi onal leg length refl ex (FLLR), which is an Achilles deep tendon refl ex performed in the prone positi on, where we are not concerned about leg length or making the legs even. Rather it is an objecti ve neurological exam that rules out secondary and terti ary subluxati ons and objecti vely identi fi es the primary subluxati on.
Another is to recognize and understand that the subluxati on is not the bone, but the bone subluxates. The subluxati on is a neurological projecti on in three-dimensional space in an X, Y and Z axis, known as the listi ng. Adjustments are made with the Integrator® which is the only instrument that reproduces all of the correcti ons and three dimensional moti ons including torque that the hands perform to produce a toggle recoil adjustment that fi res independent of the practi ti oner. It is the fi rst chiropracti c instrument to be registered and indicated for the adjustment of the vertebral subluxati on by the U.S. government.
It is our positi on that all techniques work, but it is the art of the practi ce of the individual chiropractor that makes that possible, not the technique itself. TRT is the only technique to be created out of a randomized clinical trial which was published by the presti gious journal Nature. All other techniques have been created by mind’s eye with their research aft er the fact and are based on a linear, mechanisti c Newtonian model which is why all fi rst century techniques are not allowed to change. This additi onal diff erence allows TRT to constantly change and upgrade itself several ti mes a year based on the constant fl ow of incoming research from many fi elds worldwide.
This allows us to set the stage in understanding what the future will look like for TRT. TRT will provide a holographic theater platf orm during adjustments which will automati cally download into the medical record and validate adjustment interventi on. Eventually the FLLR menti oned above will be replaced and upgraded by table mounted digital sensors that will record and identi fy our FLLR neurological leg check and automati cally download the fi ndings in the medical record. The future Integrator® will be digiti zed and be able to provide advanced harmonic frequency cloaking which will match the primary subluxati on's HZ frequency to provide a more sustainable adjustment.
This will also allow for each adjustment to retrace multi ple layers at a ti me instead of today's retracing only one layer at a ti me. Vortex safety sensors in the Integrator® will guarantee and confi rm the exact alignment of the required lines of drive in the X, Y and Z axis of the listi ng including its superior or inferior lines of drive also known as the torque, prior to allowing the Integrator® to adjust.
Even the method in the teaching and training of TRT will be strikingly different in the future. TRT's training and teaching will come into the home or office of the chiropractor in the form of a holographic platform, which will provide instantaneous corrections to any mistakes made by the chiropractor during training. This will allow chiropractors to att ain maximum and intraprofessional reproducibility and profi ciency in performing TRT in the clinical setti ng, without having to att end a seminar or learn about a hands-on technique online.
In 1986 Dr. Larry Webster formed the Internati onal Chiropracti c Pediatric Associati on (ICPA) with a simple mission: all children deserve chiropracti c care. Then, like now, it was apparent that children were in desperate need of chiropracti c care and its intrinsic benefi t to the central nervous system. Tragically, exposure to a myriad environmental, emoti onal and physical stressors has been on the rise. It was no less than visionary to recognize that the future of health was in supporti ng the spine and nervous system as early as possible rather than allowing the dysfuncti onal neurological patt erns to develop and persist.
This message was no doubt inspiring for many chiropractors drawn intuiti vely to the care of babies and children. One such inspired chiropractor was my mother, Dr. Jeanne Ohm, who fi rst became involved with the ICPA aft er taking a class with Dr. Webster in 1995. Already seeing many families in practi ce, it was a twist of fate and a drive to bett er serve her community that drew her to take these classes and aft er being exposed to Dr. Joe Felicia’s class on birth trauma, a fi re was lit inside her.
If, when caring for a child’s spine and nervous system, earlier is bett er, then supporti ng the mother during pregnancy and thereby minimizing the initi al trauma to the baby is best. Aft er Dr. Webster’s unti mely passing in 1997, my mother became more involved in the ICPA, developing the Webster Technique into a certi fi cati on in 2000 and eventually taking on the role of executi ve director in 2002. Since then, more than 10,000 chiropractors have been trained in the Webster Technique impacti ng a truly remarkable number of births and therefore babies around the world.
The fulfi llment of chiropracti c is in taking care of the family as a whole. Over the past decade, the relevance of a salutogenic rather than reacti ve or pathogenic approach to health
has become apparent. My mom, and by extension the greater ICPA membership, have called this focus “the chiropracti c family lifestyle.” Those of us who focus on family care in practi ce know that families who seek out regular chiropracti c care have a unique and powerful trust in their body’s ability to express life. It is subtle at fi rst, a curiosity that brings them into the offi ce, but like a seed in rich garden soil, it grows into a lasti ng confi dence that supports the journey of that family.
With confi dence comes resilience. More and more families are discovering the supporti ve role that chiropracti c care provides for them. A focused model of care that is directed towards functi onal improvements rather than symptomati c abatement and perhaps most importantly, that respects and honors the body’s own innate capacity to heal and regenerate, is a powerful and liberati ng perspecti ve to embody. The family chiropractor is in a unique and privileged role to deliver this perspecti ve. This is so vital in a world seemingly paralyzed by fear.
Chiropractors have always possessed a radical, innate perspecti ve, and I feel this is not about to change, nor should it. In fact, what we need now, more than ever, is for chiropractors to step up in their communiti es and serve the many families that are choosing a more proacti ve trusti ng directi on for their health and functi on. Chiropracti c care at its very core has always been focused on the functi on of the nervous
system and the powerful eff ect it has on all aspects of wellbeing. We would be wise to recognize the importance of this focus. In his last printed words, BJ Palmer said: “May your innate receive and act on that free fl ow of Wisdom from above-down, inside-out… for you have in your possession a Sacred Trust. Guard it well.”
We must stand for the families in our communiti es and off er to them the understanding of the chiropracti c family lifestyle, trust in the power of healing, awareness of our innate potenti al, nurturing the realizati on of health, and confi dent in the wisdom of “life expresses intelligence.” We are in fact the ones they have been waiti ng for. The nervous system is the key; chiropractors care for the nervous system; all children and pregnant women and families deserve chiropracti c care. We must not forget that.
THE FULFILLMENT OF FAMILY CHIROPRACTIC CARE
Justi n Ohm, DC
Deed E. Harrison, DC
CBP technique interventions are known to improve patients’ pain, disability, quality of life, and neurophysiological measures in those su ering and presenting with abnormal spine and posture structural deformities (subluxations).
CBP (Chiropracti c Biophysics) pati ent management protocol involves all typical initi al pati ent examinati on procedures including the consultati on, examinati on and pain, disability and quality of life questi onnaires. In additi on, CBP treatment considerati on requires, without excepti on, a fullspine posture assessment as well as full-spine AP and lateral standing spinal radiographs. Posture needs to be quanti tati vely assessed as rotati ons and translati ons of the head, thorax and pelvis in three-dimensions. The x-rays need to be digiti zed and quanti fi ed, using the Harrison posterior tangent method for the sagitt al images and with the modifi ed Risser-Ferguson on the AP images.
CBP structural rehabilitati on is suggested as either 3 ti mes per week for 12 weeks (36 treatments) or 4 ti mes per week for 9 weeks (36 treatments). However, the CBP published controlled trial data support treatment blocks of 30-40 treatment sessions over the course of 9-12 weeks. An initi al pati ent who has acute or chronic pains and who has not been treated recently or at all for their current spine issue should be seen for an initi al 6-12 treatments to provide pain relief. Aft er signs of relief have occurred, a progress exam should be performed and the pati ent should be transiti oned or ‘graduated’ to CBP correcti ve care interventi ons.
CBP treatment occurs in ‘blocks of care.’ Numerous CBP controlled clinical trials provide evidence for spine altering changes to occur in the range of 30-40 treatment sessions. The end of each block of CBP care requires a progress exam which includes all of the typical assessment procedures as well as a posture and x-ray assessment. Exam results may either dictate the need for further CBP treatment or the recommendati on for ‘supporti ve’ or maintenance care. An initi al block of CBP structural rehabilitati on will include any acute care provided in the fi rst 2-4 weeks.
While the CBP published research data does not specifi cally support 6-12 month care plans, based on the available data, an adult typically needs 6 months of correcti ve care (e.g. 72 treatments over 6 months at 3x/week) which is an evidence-based recommendati on based on results from randomized trials. Although, any given pati ent may require a shortened (i.e. 1-2 months) or longer treatment programs (6-12 months) based on their initi al presenti ng postural, spinal, and pain and disability parameters. There is also support for supporti ve/ maintenance care at a frequency of approximately 1-2x/month. CBP technique has an abundance of clinical evidence supporti ng its eff ecti veness in correcti ng spine deformity and abnormal posture. Recently, systemati c reviews have summarized the clinical evidence as reported in the published controlled trials on these methods for the cervical and lumbar regions.
CBP technique interventi ons are known to improve pati ents’ pain, disability, quality of life, and neurophysiological measures in those suff ering and presenti ng with abnormal spine and posture structural deformiti es (subluxati ons). Due to the scienti fi c credibility of CBP’s 240 (plus) peer-reviewed publicati ons, the Internati onal Chiropractor’s Associati on (ICA) has awarded CBP Technique with a professional Diplomate Program - the new 420 hour CBP Diplomate led by Dr. Deed Harrison (see www.IdealSpine.com for details). Due to the economic and health benefi ts of CBP Technique methods and the global burden of spine disorders, CBP technique should conti nue to grow in the chiropracti c, physical medicine, and general rehabilitati on setti ngs for spine disorders and for pati ent health and well-being. CBP will conti nue to publish high quality research and develop bett er pati ent interventi on strategies. As such, it should rightly take its place as a leading pati ent rehabilitati on approach for the correcti on of spine and posture abnormaliti es in Chiropracti c Educati on and Technique.
